Glycated albumin predicts the effect of dual and single antiplatelet therapy on recurrent stroke

Li, J.; Wang, Y.; Wang, D.; Lin, Jinxi; Wang, A.; Zhao, Xiliang; Liu, L.; Wang, C.

doi:10.1212/wnl.0000000000001421

Cited by 32 publications

(33 citation statements)

References 26 publications

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“…The meta‐analysis combining the CHANCE study with 13 previous studies of other populations in the world showed consistent conclusions . Later, glycated albumin level below the cut point of 15.5% implied an additional benefit of DAPT versus monotherapy, with a significant reduction in risks of stroke recurrence (adjusted HR 0.40, 95% CI 0.26–0.61, P < 0.001) and combined vascular events (adjusted HR 0.39, 95% CI 0.26–0.60, P < 0.001) and a nonelevated risk of bleeding (adjusted HR 1.87, 95% CI 0.71–4.92, P = 0.204) in a subgroup analysis of the CHANCE study with total 3044 patients . This study showed that the level of glycated albumin could be a new biomarker in antiplatelet decision‐making.…”

Section: Patients With Noncardioembolic Ischemic Strokementioning

confidence: 51%

Dual Antiplatelet Therapy of Clopidogrel and Aspirin in Secondary Prevention of Ischemic Stroke: Evidence and Indications

Cheng

Dong

2015

CNS Neurosci Ther

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Nowadays the dual antiplatelet therapy (DAPT) becomes more widely used in patients with ischemic stroke. Nevertheless, controversies exist for indications of DAPT. In view of evidence-based medicine analysis, patients with high-risk transient ischemic attack and minor stroke, severe symptomatic intracranial artery stenosis, symptomatic intracranial and extracranial artery stenosis causing artery-to-artery embolism, ischemic stroke attributed to aortic arch plaques, high-risk atrial fibrillation not suitable for oral anticoagulants, intracranial and extracranial stent implantation, and ischemic stroke with acute coronary syndrome may gain great benefit from DAPT of clopidogrel and aspirin. In clinical practice, individualized antiplatelet therapy strategies should be taken by weighing risks of ischemia and hemorrhage.

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Section: Patients With Noncardioembolic Ischemic Strokementioning

confidence: 51%

Dual Antiplatelet Therapy of Clopidogrel and Aspirin in Secondary Prevention of Ischemic Stroke: Evidence and Indications

Cheng

Dong

2015

CNS Neurosci Ther

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“…Blood pressure was measured in the left arm of supine patients using a mercury or electronic sphygmomanometer. Venous blood was drawn from fasting patients 24±12 hours after randomization in 3044 patients of these 73 centers 21. Plasma glucose after overnight fasting was then analyzed.…”

Section: Methodsmentioning

confidence: 99%

“…Venous blood was drawn from fasting patients 24AE12 hours after randomization in 3044 patients of these 73 centers. 21 Plasma glucose after overnight fasting was then analyzed. The serum specimens were collected and shipped on ice by overnight courier from each participating hospital to Beijing Tiantan Hospital (China), where all data analyses were performed.…”

Section: Measurementsmentioning

confidence: 99%

Recurrent Stroke in Minor Ischemic Stroke or Transient Ischemic Attack With Metabolic Syndrome and/or Diabetes Mellitus

Chen

Pan

Jing

et al. 2017

JAHA

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BackgroundWe aimed to determine the risk conferred by metabolic syndrome (METS) and diabetes mellitus (DM) to recurrent stroke in patients with minor ischemic stroke or transient ischemic attack from the CHANCE (Clopidogrel in High‐risk patients with Acute Non‐disabling Cerebrovascular Events) trial.Methods and ResultsIn total, 3044 patients were included. Patients were stratified into 4 groups: neither, METS only, DM only, or both. METS was defined using the Chinese Diabetes Society (CDS) and International Diabetes Foundation (IDF) definitions. The primary outcome was new stroke (including ischemic and hemorrhagic) at 90 days. A multivariable Cox regression model was used to assess the relationship of METS and DM status to the risk of recurrent stroke adjusted for potential covariates. Using the CDS criteria of METS, 53.2%, 17.2%, 19.8%, and 9.8% of patients were diagnosed as neither, METS only, DM only, and both, respectively. After 90 days of follow‐up, there were 299 new strokes (293 ischemic, 6 hemorrhagic). Patients with DM only (16.1% versus 6.8%; adjusted hazard ratio 2.50, 95% CI 1.89–3.39) and both (17.1% versus 6.8%; adjusted hazard ratio 2.76, 95% CI 1.98–3.86) had significantly increased rates of recurrent stroke. No interaction effect of antiplatelet therapy by different METS or DM status for the risk of recurrent stroke (P=0.82 for interaction in the fully adjusted model of CDS) was observed. Using the METS (IDF) criteria demonstrated similar results.ConclusionsConcurrent METS and DM was associated with an increased risk of recurrent stroke in patients with minor stroke and transient ischemic attack.

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“…The result suggests that TIA patients with low glycated albumin level could benefit from dual antiplatelet therapy. Future studies can explore possible mechanisms of the influence of glycated albumin on the response to antiplatelet agents [41]. Another serum marker is sCD40L.…”

Section: Individualized Drug Therapy and Further Studymentioning

confidence: 99%

Dual Antiplatelet Therapy with Clopidogrel and Aspirin for Secondary Stroke Prevention

Wang

Chen

2015

Curr Cardiol Rep

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Stroke is a major public health concern worldwide, and 25 % of stroke victims would have another stroke. Although administration of antiplatelet agents has been confirmed to be one of the major approaches for secondary prevention of noncardioembolic stroke, the short-term or long-term use of aspirin plus clopidogrel for secondary stroke prevention remains to be controversial. This article aims at providing a comprehensive review of the evidence on the use of aspirin plus clopidogrel for secondary stroke prevention, with special focus on important studies that may impact clinical practice of treating patients with stroke or transient ischemic attack.

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Glycated albumin predicts the effect of dual and single antiplatelet therapy on recurrent stroke

Abstract: GA could be a potential biomarker to predict the effects of dual and single antiplatelet therapy in patients with minor stroke or TIA.

Cited by 32 publications

References 26 publications

Dual Antiplatelet Therapy of Clopidogrel and Aspirin in Secondary Prevention of Ischemic Stroke: Evidence and Indications

Dual Antiplatelet Therapy of Clopidogrel and Aspirin in Secondary Prevention of Ischemic Stroke: Evidence and Indications

Recurrent Stroke in Minor Ischemic Stroke or Transient Ischemic Attack With Metabolic Syndrome and/or Diabetes Mellitus

Dual Antiplatelet Therapy with Clopidogrel and Aspirin for Secondary Stroke Prevention

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